Composite
99.0 / 100 percentile
Screener / 165580
F
Royal Oaks Nursing and Rehabilitation Center
snfIASFF: SFF Candidate
4614 NW 84th Street, Urbandale, IA 50322 · CCN 165580 · chain SAMARA FAMILY HOLDINGS LLC
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
115
Model
v1.2
Reads as: riskier than 99.0% of the 14,684 facilities in the snf peer group. percentile within peer group, 100 = highest risk. Grade bands are fixed percentile cuts (F is the top 5% of peer risk), so a grade is a position, not an absolute level.
Score model5ML signals17Components16CHOW radar1Distress radar1Staffing16Penalties4Deficiencies71Licensure0Ownership26Related party4Transactions1Comps12Market rent35
Composite explanation
5| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 96.6 | 95.2 | 0.30 | 0.2308 | 22.29 | in index |
| financial risk | 81.0 | 67.9 | 0.30 | 0.2308 | 18.69 | in index |
| billing conduct | 75.0 | 50.1 | 0.30 | 0.2308 | 17.31 | in index |
| staffing risk | 87.2 | 87.2 | 0.25 | 0.1923 | 16.77 | in index |
| chow risk | 42.5 | 42.6 | 0.15 | 0.1154 | 4.90 | in index |
weighted_contribution sums to pre_rank_index over rows where counts_toward_index is true. The composite is the facility's percentile position of that index within its peer group, so contributions explain the input, and the rank explains the score.
ML signals — parallel engine
17| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner fleet risk far above national | +47.8 vs natl | IOWA 5784 LLC | 5 facilities |
| connection | Owner fleet risk far above national | +47.2 vs natl | AMARANTHINE HOLDINGS LLC | 5 facilities |
| connection | Owner fleet risk far above national | +47.2 vs natl | JSJ 2020 FAMILY TR | 5 facilities |
| connection | Owner fleet risk far above national | +47.2 vs natl | CARESAGE ADMINISTRATIVE CONSULTING LLC | 5 facilities |
| connection | Owner fleet risk far above national | +42.1 vs natl | CEDAR VIEW TR | 6 facilities |
| connection | Owner fleet risk far above national | +41.9 vs natl | SAMARA FAM TR | 6 facilities |
| connection | Owner fleet risk far above national | +40.3 vs natl | CEDAR VIEW HOLDINGS LLC | 9 facilities |
| connection | Owner fleet risk far above national | +31.7 vs natl | JSJ PROPERTY LLC | 7 facilities |
| connection | Owner spans multiple chains | 6 chains | SUMMATION FINANCIAL SERVICES LLC | 48 facilities |
| connection | Owner spans multiple chains | 5 chains | OCONNER MICHAEL | 8 facilities |
| connection | Owner spans multiple chains | 5 chains | CLINICAL CONSULTING SERVICES LLC | 42 facilities |
| connection | Owner spans multiple chains | 5 chains | SEBBAG GABRIEL | 32 facilities |
| connection | Owner fleet enforcement cluster | 44% fined | CEDAR VIEW HOLDINGS LLC | 9 facilities |
| connection | Owner fleet enforcement cluster | 40% fined | JSJ 2020 FAMILY TR | 5 facilities |
| connection | Owner fleet enforcement cluster | 40% fined | AMARANTHINE HOLDINGS LLC | 5 facilities |
| connection | Owner fleet enforcement cluster | 40% fined | CARESAGE ADMINISTRATIVE CONSULTING LLC | 5 facilities |
| connection | Owner fleet enforcement cluster | 40% fined | IOWA 5784 LLC | 5 facilities |
Findings from the always-on scanning layer: anomalies on this facility, connections through its current owners and past buyers. Runs beside the deterministic composite, never inside it. Full board on the ML Lab page.
Component scores and registry models
16| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 50.1 | C | v0.1-pacpuf-snf | default · in composite | R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup. |
| chow risk | 24.8 | A | v0.1-pos | default · in composite | Change-of-ownership footprint in the CMS Provider of Services file: control-family, legal-name and address deltas across quarterly snapshots, plus certification reset recency and Medicare tenure. |
| chow risk | 60.3 | C | v0.6 | default · in composite | |
| financial risk | 67.9 | D | v0.5 | default · in composite | R18. |
| p adverse action 12m | 0.0 | — | v0.1 | default · in composite | R23/W4-3. Deterministic logistic p(Medicare termination within 12m), SNF only. Label = first POS termination date (any code: voluntary closure, involuntary termination, merger exit); facilities already terminated by the panel date are excluded, not counted as safe. Trained on panels 2024-07/2024-10/2025-01 (n=46,466, 283 positives), evaluated on the held-out later panel 2025-04 BEFORE shipping: AUC 0.971, top-decile lift 9.5x, top-decile capture 95.4% of the 65 terminations that followed. Separability is high because closures announce themselves in the data: collapsing occupancy is the strongest signal, and the learned NEGATIVE weight on 12m deficiency counts is the surveys-stop signature of a facility winding down, not a claim that clean inspections are dangerous. Same 15 as-of-date features and anti-leakage chassis as p_chow_12m; SFF entry rejected as a label (only one month of SFF history exists, so as-of transitions cannot be reconstructed). Score = probability x 100; grade NULL. Not in any composite. |
| p chow 12m | 0.0 | — | v0.1 | default · in composite | R22/W4-2. Deterministic logistic p(CHOW within 12m), SNF only. Trained on panels 2024-07/2024-10/2025-01 (n=50,700, 1,207 positives), evaluated on the held-out later panel 2025-04 BEFORE shipping: AUC 0.874, top-decile lift 5.0x (top 10% of predictions captured 49.6% of the CHOWs that actually closed in the next 12 months). Shipped coefficients are the evaluated ones; no post-holdout refit. Caveat: holdout positives (133) run below the training base rate because recent CHOWs surface in public records with a lag, so measured lift is conservative. Features are as-of-date public records: PBJ staffing level/trend/contract share (quarterly history to 2022Q1), deficiency and CMP counts (12m), ownership tenure and churn from CHOW-evidenced transactions, beds, occupancy, ownership type, chain size. Chain membership and ownership type are current-state (history not published). SFF and star ratings deliberately excluded (no as-of history). Notable learned direction: long ownership tenure RAISES sale odds and a recent prior CHOW lowers them. Score = probability x 100; grade is NULL because a probability is not a quality letter. Not in any composite. |
| regulatory risk | 95.2 | F | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 87.2 | F | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 84.1 | F | v0.1 | superseded | Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity. |
| financial risk | 64.1 | C | v0.2 | superseded | Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity. |
| financial risk | 63.5 | C | v0.3 | superseded | Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity. |
| financial risk | 68.7 | D | v0.4 | superseded | Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity. |
| regulatory risk | 95.2 | F | v0.1 | superseded | Pre-registry model iteration, superseded by a later regulatory_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity. |
| regulatory risk | 95.2 | F | v0.2 | superseded | Pre-registry model iteration, superseded by a later regulatory_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity. |
| staffing risk | 87.2 | F | v0.1 | superseded | Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity. |
| staffing risk | 87.2 | F | v0.2 | superseded | Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity. |
Rows with counts_toward_composite false come from models that are addressable or retracted rather than default. They exist and may be informative, but they did not enter the published composite and must not be summed as though they had.
CHOW radar — 12-month sale probability
full board →p(CHOW, 12m)
0.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
12.1
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Current owner tenure (years) | 1.57 | -1.69 | |
| Never sold on record | 0.00 | -1.62 | |
| Ownership changes, last 5 years | 1.00 | -0.87 | |
| For-profit ownership | 1.00 | +0.69 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Deficiencies, last 12 months | 15.00 | +0.19 | |
| Occupancy | 0.75 | -0.15 | |
| High-severity deficiencies, 12m | 2.00 | +0.09 |
p_adverse_action_12m: probability the facility's Medicare participation terminates within 12 months (any POS termination code; already-terminated facilities are excluded, not scored safe). Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.971, top-decile lift 9.5x. Closures announce themselves: collapsing occupancy dominates, and fewer recent surveys is a winding-down signature. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models. | p_chow_12m: probability of a change of ownership within 12 months. Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.874, top-decile lift 5.0x. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models for full notes.
Distress radar — 12-month termination probability
full board →p(termination, 12m)
0.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
10.1
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Deficiencies, last 12 months | 15.00 | -1.35 | |
| For-profit ownership | 1.00 | -0.69 | |
| Fine amount, 12m (log) | 9.74 | -0.53 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Never sold on record | 0.00 | -0.28 | |
| Current owner tenure (years) | 1.57 | -0.28 | |
| Chain size (log) | 1.61 | +0.26 | |
| Total nurse staffing (HPRD) | 2.63 | +0.25 |
Probability the facility's Medicare participation ends within 12 months, from public records only. Red bars raise exit odds. A negative pull from deficiencies is the winding-down signature — surveys stop as a facility empties — not evidence that clean inspections are dangerous.
Staffing vs peers
16| 2025Q4 HPRD | This facility | IA median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 2.63 | 3.15 | 3.28 | 2.90–3.77 |
| RN | 0.16 | 0.46 | 0.39 | 0.25–0.58 |
| Weekend total | 2.53 | 2.96 | 3.11 | — |
| Weekday total | 2.67 | 3.20 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 86.0 | 2.63 | 0.16 | 0.59 | 1.87 | 2.53 | 1.7% |
| 2025Q3 | 92 | 85.7 | 2.72 | 0.32 | 0.54 | 1.87 | 2.70 | 2.0% |
| 2025Q2 | 91 | 84.7 | 2.69 | 0.28 | 0.60 | 1.80 | 2.55 | 2.9% |
| 2025Q1 | 90 | 84.4 | 2.74 | 0.34 | 0.60 | 1.80 | 2.62 | 3.6% |
| 2024Q4 | 92 | 82.4 | 2.50 | 0.29 | 0.42 | 1.78 | 2.41 | 1.9% |
| 2024Q3 | 92 | 83.3 | 2.51 | 0.45 | 0.23 | 1.83 | 2.52 | 2.9% |
| 2024Q2 | 91 | 90.0 | 2.52 | 0.41 | 0.33 | 1.78 | 2.39 | 2.9% |
| 2024Q1 | 91 | 87.4 | 2.70 | 0.43 | 0.36 | 1.90 | 2.59 | 9.3% |
| 2023Q4 | 92 | 83.4 | 3.04 | 0.66 | 0.43 | 1.95 | 3.06 | 20.6% |
| 2023Q3 | 92 | 83.8 | 3.18 | 0.45 | 0.45 | 2.28 | 3.04 | 14.9% |
| 2023Q2 | 91 | 82.1 | 3.33 | 0.31 | 0.70 | 2.31 | 3.26 | 16.4% |
| 2023Q1 | 90 | 77.6 | 3.23 | 0.41 | 0.59 | 2.23 | 3.11 | 9.0% |
| 2022Q4 | 92 | 77.7 | 3.18 | 0.38 | 0.56 | 2.25 | 2.96 | 7.5% |
| 2022Q3 | 92 | 86.1 | 3.03 | 0.25 | 0.46 | 2.32 | 2.88 | 10.4% |
| 2022Q2 | 91 | 86.3 | 3.29 | 0.38 | 0.54 | 2.37 | 3.23 | 10.2% |
| 2022Q1 | 90 | 81.6 | 3.53 | 0.30 | 0.61 | 2.62 | 3.52 | 7.6% |
HPRD is census-weighted: total hours over the quarter divided by total resident-days, not an average of daily ratios. Source is CMS Payroll-Based Journal daily records; only SNFs report PBJ, so other settings legitimately return zero rows.
Penalties
4fines by year
| Date | Type | Fine | Source |
|---|---|---|---|
| 2025-10-22 | Fine | $16,907 | CMS provider data |
| 2024-12-12 | Fine | $71,136 | CMS provider data |
| 2023-12-06 | Fine | $34,902 | CMS provider data |
| 2023-12-06 | Payment Denial | — | CMS provider data |
Total fines on record: $122,945
Deficiencies
71C × 1D × 45E × 17F × 1G × 5J × 1K × 1
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-04-09 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | — |
| 2026-04-09 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | — |
| 2026-04-09 | Health · complaint | F0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | — |
| 2026-04-09 | Health · complaint | F0760 | Ensure that residents are free from significant medication errors. | D | — |
| 2026-04-09 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | D | — |
| 2026-02-11 | Health · complaint | F0554 | Allow residents to self-administer drugs if determined clinically appropriate. | D | 2026-02-23 |
| 2026-02-11 | Health · complaint | F0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | E | 2026-02-23 |
| 2026-02-11 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2026-02-23 |
| 2026-02-11 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | — |
| 2026-02-11 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2026-02-23 |
| 2026-02-11 | Health · complaint | F0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | G | — |
| 2026-02-11 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | E | — |
| 2025-10-22 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2025-11-07 |
| 2025-10-22 | Health · complaint | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | K | 2025-10-09 |
| 2025-10-22 | Health · complaint | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2025-11-07 |
| 2025-05-20 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2025-06-13 |
| 2025-05-20 | Health | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | 2025-06-13 |
| 2025-05-20 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2025-06-13 |
| 2025-05-20 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2025-06-13 |
| 2025-05-20 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2025-06-13 |
| 2025-05-20 | Health · complaint | F0740 | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | D | 2025-06-13 |
| 2025-05-20 | Health · complaint | F0760 | Ensure that residents are free from significant medication errors. | G | 2025-06-13 |
| 2025-05-20 | Health · complaint | F0761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | 2025-06-13 |
| 2025-05-20 | Health | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2025-06-13 |
| 2025-05-20 | Health · complaint | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2025-06-13 |
| 2025-05-20 | Health | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | E | 2025-06-13 |
| 2025-05-20 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2025-06-13 |
| 2024-12-13 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | 2025-01-17 |
| 2024-12-13 | Health · complaint | F0558 | Reasonably accommodate the needs and preferences of each resident. | E | 2025-01-17 |
| 2024-12-13 | Health · complaint | F0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | E | 2025-01-17 |
| 2024-12-13 | Health · complaint | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | 2025-01-17 |
| 2024-12-13 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2025-01-17 |
| 2024-12-13 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | 2025-01-17 |
| 2024-12-13 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | E | 2025-01-17 |
| 2024-12-13 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2025-01-17 |
| 2024-12-13 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | J | 2025-01-17 |
| 2024-12-13 | Health · complaint | F0761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | 2025-01-17 |
| 2024-12-13 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | D | 2025-01-17 |
| 2024-12-13 | Health · complaint | F0925 | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | E | 2025-01-17 |
| 2024-10-15 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2024-11-07 |
| 2024-10-15 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | 2024-11-07 |
| 2024-10-15 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2024-11-07 |
| 2024-09-07 | Health · complaint | F0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | 2024-09-25 |
| 2024-07-01 | Health | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2024-08-01 |
| 2024-07-01 | Health | F0578 | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | D | 2024-08-01 |
| 2024-07-01 | Health · complaint | F0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | 2024-08-01 |
| 2024-07-01 | Health | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2024-08-01 |
| 2024-07-01 | Health | F0610 | Respond appropriately to all alleged violations. | D | 2024-08-01 |
| 2024-07-01 | Health | F0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | D | 2024-08-01 |
| 2024-07-01 | Health | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | 2024-08-01 |
| 2024-07-01 | Health | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | 2024-08-01 |
| 2024-07-01 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2024-08-01 |
| 2024-07-01 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2024-08-01 |
| 2024-07-01 | Health | F0868 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | D | 2024-08-01 |
| 2024-07-01 | Health | F0926 | Have policies on smoking. | D | 2024-08-01 |
| 2024-01-30 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2024-02-13 |
| 2024-01-30 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | E | 2024-02-13 |
| 2024-01-30 | Health · complaint | F0921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | 2024-02-13 |
| 2023-12-06 | Health · complaint | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | 2023-12-27 |
| 2023-12-06 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2023-12-27 |
| 2023-12-06 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | G | 2023-12-19 |
| 2023-12-06 | Health · complaint | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | G | 2023-12-19 |
| 2023-12-06 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2023-12-27 |
| 2023-09-07 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2023-09-29 |
| 2023-09-07 | Health · complaint | F0761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | 2023-09-29 |
| 2023-04-04 | Health | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | 2023-05-04 |
| 2023-04-04 | Health | F0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | C | 2023-05-04 |
| 2023-04-04 | Health | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | 2023-05-04 |
| 2023-04-04 | Health | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2023-05-04 |
| 2023-04-04 | Health | F0803 | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | E | 2023-05-04 |
| 2023-04-04 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2023-05-04 |
scope_severity uses the CMS letter grid: A is least serious, L most. J, K and L are immediate jeopardy. Rows are the surveyor's findings of record, not the model's opinion.
Licensure actions
0No licensure actions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Ownership
26| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| AMARANTHINE HOLDINGS LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2025-01-01 | current | pecos_ownership |
| 4614 NW 84TH STREET PROPCO LLC | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| CARESAGE ADMINISTRATIVE CONSULTING, LLC | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| CEDAR VIEW HOLDINGS LLC | ADP OF THE SNF | — | 2025-03-25 | current | pecos_ownership |
| CEDAR VIEW HOLDINGS LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2025-01-01 | current | pecos_ownership |
| CEDAR VIEW TR | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2025-01-01 | current | pecos_ownership |
| CEDAR VIEW TR | ADP OF THE SNF | — | 2025-03-25 | current | pecos_ownership |
| CLINICAL CONSULTING SERVICES LLC | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| GREATOREX, TINA | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2025-01-01 | current | pecos_ownership |
| IOWA 5784 LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2025-01-01 | current | pecos_ownership |
| IOWA 5784 LLC | ADP OF THE SNF | — | 2025-03-25 | current | pecos_ownership |
| JSJ 2020 FAMILY TR | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| JSJ PROPERTY LLC | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| OCONNER, MICHAEL | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| REITER, JENNIFER | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| SAMARA FAM TR | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| SAMARA FAMILY HOLDINGS LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2025-01-01 | current | pecos_ownership |
| SCHIOWITZ, MARC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2025-01-01 | current | pecos_ownership |
| SEBBAG, GABRIEL | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2025-01-01 | current | pecos_ownership |
| SUMMATION FINANCIAL SERVICES LLC | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| THE BRYN MAWR TRUST COMPANY OF DELAWARE | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| MARC SCHIOWITZ | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2025-01-01 | ended 2026-05-18 | pecos_ownership |
| TINA GREATOREX | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2025-01-01 | ended 2026-05-18 | pecos_ownership |
| GABRIEL SEBBAG | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 52% | 2025-01-01 | ended 2026-05-18 | pecos_ownership |
| JENNIFER REITER | ADP OF THE SNF | — | 2025-01-01 | ended 2026-05-18 | pecos_ownership |
| MICHAEL OCONNER | ADP OF THE SNF | — | 2025-01-01 | ended 2026-05-18 | pecos_ownership |
PECOS ownership and managing-control associations. Current edges have no end date in the source; historical edges are retained.
Transactions
1| Close date | Price | Buyer | Seller | Evidence |
|---|---|---|---|---|
| 2025-01-01 | — | ROYAL OAKS NURSING AND REHABILITATION CENTER LLC | OPCO URBANDALE IA LLC | chow |
Comparable trades — IA snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-09-01 | St Luke's Regional Medical Center SNF | — | — | — | 20 | NORTHWEST IOWA HOSPITAL CORPORATION |
| 2025-08-01 | Crystal Heights Care Center | — | — | — | 72 | CANFIELD RIVER HEALTHCARE LLC |
| 2025-06-01 | AMS Memorial-Greene | — | — | — | 31 | AMS MEMORIAL-GREENE LLC |
| 2025-02-05 | Chapters Living of Council Bluffs | — | — | — | 102 | CHAPTERS COUNCIL BLUFFS OPCO LLC |
| 2025-02-01 | Osage Rehab and Health Care Center | — | — | — | 46 | OPCO OSAGE IA LLC |
| 2025-02-01 | Iowa City Rehab & Health Care | — | — | — | 89 | OPCO IOWA CITY IA LLC |
| 2025-02-01 | Accura Healthcare of Creston | — | — | — | 31 | ACCURA HEALTHCARE OF CRESTON LLC |
| 2025-02-01 | Casa De Paz Health Care Center | — | — | — | 71 | OPCO 19TH ST SIOUX CITY IA LLC |
| 2025-02-01 | Pleasant Acres Care Center | — | — | — | 46 | OPCO HULL IA LLC |
| 2025-02-01 | Cedar Falls Health Care Center | — | — | — | 70 | OPCO CEDAR FALLS IA LLC |
| 2025-02-01 | Accura Healthcare of Onawa | — | — | — | 46 | ACCURA HEALTHCARE OF ONAWA LLC |
| 2025-02-01 | Grundy Care Center | — | — | — | 40 | OPCO GRUNDY CENTER IA LLC |
Most recent same-state, same-setting trades. Most CHOW-derived trades carry no disclosed consideration, so price, $/bed, and cap rate show only where a sale price was resolved from a deed or filing — blanks are honest, not missing data.
Market rent context
35| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 19153 | acs median gross | 0 | $926 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | fmr | 0 | $1,063 | 2025-10-01 | HUD_USER_FMR |
| county 19153 | acs median gross | 1 | $963 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | fmr | 1 | $1,109 | 2025-10-01 | HUD_USER_FMR |
| county 19153 | acs median gross | 2 | $1,169 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | fmr | 2 | $1,318 | 2025-10-01 | HUD_USER_FMR |
| county 19153 | acs median gross | 3 | $1,497 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | fmr | 3 | $1,794 | 2025-10-01 | HUD_USER_FMR |
| county 19153 | acs median gross | 4 | $1,605 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | fmr | 4 | $1,841 | 2025-10-01 | HUD_USER_FMR |
| county 19153 | acs median gross | 5 | $1,834 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | acs median gross | $1,149 | 2024-12-31 | CENSUS_ACS5 | |
| county 19153 | acs recent mover gross | $1,235 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 50322 | acs median gross | 0 | $1,012 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50322 | acs median gross | 1 | $1,057 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50322 | acs median gross | 2 | $1,138 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50322 | acs median gross | 3 | $1,631 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50322 | acs median gross | 4 | $1,556 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50322 | acs median gross | $1,186 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 50322 | acs recent mover gross | $1,048 | 2024-12-31 | CENSUS_ACS5 | |
| zip 50322 | payment standard 110 | 0 | $1,177 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50322 | payment standard 90 | 0 | $963 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50322 | safmr | 0 | $1,070 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50322 | payment standard 110 | 1 | $1,232 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50322 | payment standard 90 | 1 | $1,008 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50322 | safmr | 1 | $1,120 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50322 | payment standard 110 | 2 | $1,463 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50322 | payment standard 90 | 2 | $1,197 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50322 | safmr | 2 | $1,330 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50322 | payment standard 110 | 3 | $1,991 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50322 | payment standard 90 | 3 | $1,629 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50322 | safmr | 3 | $1,810 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50322 | payment standard 110 | 4 | $2,046 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50322 | payment standard 90 | 4 | $1,674 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50322 | safmr | 4 | $1,860 | 2025-10-01 | HUD_USER_SAFMR |
ACS median gross rents and HUD FMR/SAFMR for the facility's county and ZIP. Context for underwriting, not facility pricing.